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Vol. 57. Issue 3.
Pages 193-200 (May - June 2015)
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Vol. 57. Issue 3.
Pages 193-200 (May - June 2015)
Update in Radiology
Radiological assessment of placement of the hysteroscopically inserted Essure permanent birth control device
Valoración radiológica del anticonceptivo permanente de inserción histeroscópica Essure
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R.M. Lorente Ramosa,
Corresponding author
, J. Azpeitia Armána, P. Aparicio Rodríguez-Miñónb, F.J. Salazar Arquerob, J.C. Albillos Merinoc
a Unidad Central de Radiodiagnóstico de la Comunidad de Madrid, Hospital Infanta Leonor, Madrid, Spain
b Servicio de Ginecología y Obstetricia, Hospital Infanta Leonor, Madrid, Spain
c Unidad Central de Radiodiagnóstico de la Comunidad de Madrid, Hospital Infanta Sofía, Madrid, Spain
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Table 1. Position and occlusion criteria of the Essure device.
Abstract

Essure is a permanent birth control device that is inserted through the cervix by hysteroscopy. The device is placed in the fallopian tubes, where it causes occlusion by stimulating fibrosis. Patients can be followed up with plain-film X-rays, hysterosalpingography, and ultrasonography, although the devices can also be identified incidentally on CT and MRI. The follow-up of Essure is based on checking the criteria for appropriate positioning and correct functioning (tubal occlusion) and on diagnosing complications. The most common complications are perforation, migration (toward the uterine or peritoneal cavity), and occlusion failure. In hysterosalpingography, vascular intravasation is the most common cause of diagnostic error. Radiologists need to know how to recognize the device on different imaging techniques, how to check that it is correctly placed and functioning, and how to diagnose complications.

Keywords:
Hysterosalpingography
Ultrasonography
Female sterilization
Hysteroscopic sterilization with Essure
Resumen

Essure es un dispositivo anticonceptivo permanente de inserción transcervical con histeroscopia. Se sitúa en las trompas a las que ocluye estimulando la fibrosis. Las técnicas para seguir a las pacientes son la radiografía simple, histerosalpingografía y ecografía, aunque los dispositivos se pueden identificar también incidentalmente con TC y RM. El seguimiento de Essure se basa en comprobar los criterios de posición adecuada y funcionamiento correcto (oclusión tubárica), y diagnosticar complicaciones. Las complicaciones más frecuentes son la perforación, migración (hacia la cavidad uterina o peritoneal), y fallo de la oclusión. La intravasación vascular es la causa más frecuente de error diagnóstico con la histerosalpingografía. Es importante que el radiólogo reconozca el dispositivo en las diferentes técnicas de imagen, los signos que indican que su situación y función son correctas y diagnosticar las complicaciones.

Palabras clave:
Histerosalpingografía
Ecografía
Esterilización femenina
Esterilización histeroscópica con Essure

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